一种通过胃黏膜下隧道剥离术进行内镜下幽门肌切开术的新技术。
A new technique for performing endoscopic pyloromyotomy by gastric submucosal tunnel dissection.
作者信息
Chaves Dalton M, Gusmon Carla C, Mestieri Luiz H M, de Moura Eduardo G H, Veras Mariana M, Pessorrusso Fernanda C S, Sakai Paulo
机构信息
*Serviço de Endoscopia Gastrointestinal-Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo †Department of Pathology, University of São Paulo, School of Medicine, São Paulo, SP, Brazil.
出版信息
Surg Laparosc Endosc Percutan Tech. 2014 Jun;24(3):e92-4. doi: 10.1097/SLE.0b013e31829cec0e.
AIM
To investigate the feasibility of a new endoscopic pyloromyotomy technique.
MATERIALS AND METHODS
Endoscopic pyloromyotomy through a gastric submucosal tunnel was performed in 6 pigs. At the greater curvature, 2 cm proximal to the pylorus, we incised the mucosa and dissected the submucosal tunnel up to the pyloric ring. The pyloric muscular ring was sectioned, and then the gastric mucosal incision was closed with metallic clips. The pigs were then euthanized and necropsies were performed.
RESULTS
Section of the pyloric ring was successful in all 6 pigs. Small perforations occurred in 2 of the pigs, and there was limited bleeding in 1 pig. Necropsy and histologic evaluation confirmed the pyloric section.
CONCLUSIONS
This technique is feasible, easy to perform, and maybe alternative to pyloroplasty in selected cases. Experimental comparative studies with other techniques still must be performed.
目的
探讨一种新的内镜下幽门肌切开术技术的可行性。
材料与方法
对6头猪实施经胃黏膜下隧道的内镜下幽门肌切开术。在幽门近端大弯侧2 cm处，切开黏膜并向上分离黏膜下隧道直至幽门环。切断幽门肌环，然后用金属夹封闭胃黏膜切口。随后对猪实施安乐死并进行尸检。
结果
6头猪的幽门环切断均成功。2头猪出现小穿孔，1头猪有少量出血。尸检和组织学评估证实了幽门切断。
结论
该技术可行，操作简便，在特定病例中可能替代幽门成形术。仍需与其他技术进行实验性对比研究。
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